Fragmented Readmissions From a Nursing Facility in Medicare Beneficiaries.

Autor: Turbow SD; Division of General Internal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.; Department of Family & Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA., Perkins MM; Division of Geriatrics & Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA., Vaughan CP; Division of Geriatrics & Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.; Department of Veterans Affairs Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA., Klemensen T; Division of Geriatrics & Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA., Culler SD; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA., Rask KJ; Alliant Health Solutions, Atlanta, GA, USA., Clevenger CK; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA., Ali MK; Department of Family & Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA.; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Jazyk: angličtina
Zdroj: Journal of applied gerontology : the official journal of the Southern Gerontological Society [J Appl Gerontol] 2024 Nov; Vol. 43 (11), pp. 1762-1771. Date of Electronic Publication: 2024 May 26.
DOI: 10.1177/07334648241254282
Abstrakt: Over one-third of Medicare beneficiaries discharged to nursing facilities require readmission. When those readmissions are to a different hospital than the original admission, or "fragmented readmissions," they carry increased risks of mortality and subsequent readmissions. This study examines whether Medicare beneficiaries readmitted from a nursing facility are more likely to have a fragmented readmission than beneficiaries readmitted from home among a 2018 cohort of Medicare beneficiaries, and examined whether this association was affected by a diagnosis of Alzheimer's Disease (AD). In fully adjusted models, readmissions from a nursing facility were 19% more likely to be fragmented (AOR 1.19, 95% CI 1.16, 1.22); this association was not affected by a diagnosis of AD. These results suggest that readmission from nursing facilities may contribute to care fragmentation for older adults, underscoring it as a potentially modifiable pre-hospital risk factor for fragmented readmissions.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Turbow reports expert testimony for Hovde Dassow + Deets. No other conflict of interests exist.
Databáze: MEDLINE